Endocrinology of Pregnancy Flashcards

1
Q

Where is tubular fluid reabsorbed and what controls this process?

A

Rete testis
Early epididymis
This is under the control of oestrogen

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2
Q

Where do you find oestrogen within the male reproductive tract?

A

Tubular fluid produced by sertoli cells

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3
Q

What stimulates the release of nutrients and other molecules (e.g. glycoproteins) into the epididymal fluid?

A

Androgens

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4
Q

What are the roles of these secreted nutrients and molecules?

A

Provide energy for the impending journey

Coat the surface of the spermatozoon (to protect them from the hostile environment)

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5
Q

Within which part of the male reproductive tract is fluid reabsorbed and secretory products put in?

A

Epididymis

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6
Q

Why is the concentration of sperm in the vas deferens higher than further down the reproductive tract?

A

Further down the reproductive tract, other fluids and secretory products are added thus diluting the sperm.

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7
Q

Why is there fibrinogen and fibrinolytic enzymes in the seminal fluid?

A

After ejaculation, the semen initially clots and then must be broken down

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8
Q

Describe the capabilities of the spermatozoa in the vas deferens.

A

Capable of limited movement

Limited capability to fertilise an ovum

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9
Q

Which steroid precursor tends to be provided by the mother for the foetus?

A

Pregnenolone

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10
Q

Which androgen is formed by the maternal and foetal adrenals?This is used as a precursor for oestrogen production.

A

Dehydroepiandrosterone Sulphate (DHEAS)

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11
Q

Which oestrogens are produced by the placenta using DHEAS from the mother and foetus?

A

Oestradiol

Oestrone

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12
Q

What is the main oestrogen of pregnancy? Describe how it is produced.

A

OESTRIOL
DHEAS from the foetal adrenals is conjugated in the foetal liver to form 16-alpha-hydroxy DHEAS
16-alpha-hydroxy DHEAS is then de-conjugated in the placenta and used to produce oestriol

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13
Q

What can be measured to gage the health of the foetus?

A

Oestriol: oestradiol + oestrone levels
Oestriol: total oestrogens

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14
Q

What biochemical change is required for contraction of the uterus during parturition?

A

Increase in intracellular calcium concentration

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15
Q

Describe how oestrogen increases the chance of contraction.

A

Oestrogen binds to oestrogen receptors and triggers the synthesis of prostaglandins within the endometrial cells.
Prostaglandins stimulate the release of calcium from intracellular stores.
So oestrogen tends to increase the chance of contraction

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16
Q

Describe how oxytocin increases the chance of contraction.

A

Oxytocin binds to its receptor on the endometrial cell and opens calcium channels, allowing calcium ions to move in from outside

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17
Q

Describe the effect of progesterone on this contraction process.

A

Progesterone keeps the effects of oestrogen under control
Progesterone inhibits oestrogen receptors
Progesterone inhibits the production of prostaglandins

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18
Q

What change occurs when the foetus reaches a particular size, which is crucial for contraction to take place?

A

There is a switch in steroid synthesis from progesterone synthesis to oestrogen synthesis
This leads to oestrogen dominance –> prostaglandin production –> calcium release from intracellular stores –> promotion of muscle contraction

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19
Q

What 2 hormones are involved in milk production and milk ejection?

A

Prolactin – milk production
Oxytocin – milk ejection
These both have a similar neuroendocrine reflex arc stimulated by suckling

20
Q

Contents of semen

A

Sperm
Seminal fluid
Leukocytes

21
Q

Where does most seminal fluid come from

A

Seminal vesicles
Prostate
Bulbourethral

22
Q

Role of capacitation

A

Achieve fertilising capacity of spermicide in female repro tract

23
Q

3 parts to capacitation

A

Loss of glycoprotein coat
Change in surface membrane characteristic
Whiplash movements of tail

24
Q

What is capacitation dependent of

A

Ca and oestrogen

25
Upon what does acrosome reaction occur
Binding to ZP3 glycoprotein of follicle
26
What does binding to ZP3 receptor stimulate
Ca influx
27
What is Ca2+ influx dependent of in acrosome reaction
Progesterone
28
What is effect of Ca influx in acrosome reaction
Release of hyaluronidase and proteolytic enzymes | Allows penetration of zone pellucida
29
Where does fertilisation occur
Fallopian tube
30
What does fertilisation trigger
Cortical reaction
31
Purpose of cortical reaction
Prevents further entry of sperm as degrades the zone pelluicda mainly the ZP3 and ZP2 receptors
32
Immediate development of conceptus
Can last up to 10 days but normally 3-4 | Continues to divide all the way down to uterus
33
How does developing conceptus receive nutrients
Uterine secretions
34
Stages to implantation
Attachment | Decidualisation
35
What happens in attachment stage
Outer trophoblast cells contact uterine surface epithelium
36
What happens in decidualisation stage
Changes in underlying uterine stromal tissue
37
What’s needed for decidualisation stage
Progesterone dominating oestrogen
38
Important molecules in attachment of blastocyst
Leukaemia inhibitory factor | Interleukin 11
39
What secretes LIF
Endometrial secretory glands and maybe blastocyst
40
Role of LIF
Adhesion
41
What secretes IL11
Endometrial cells for adhesion
42
Main factor involved in decidualisation
IL11
43
Changesseen in endometrium during decidualisation
Glandular epithelial secretion Glycogen accumulation in stromal cytoplasm Growth of capillaries Increased vascular permeability
44
Production of oestrogen and progesterone in first 40 days of pregnancy
Corpus luteum
45
What stimulates production of oestrogen and progesterone in first 40 days of pregnancy
hCG from trophoblasts acting on LH receptors
46
Role of oestrogen and progesterone in pregnancy
Essential for developing fetoplacental unit | Inhibits maternal LH and FSH